Extracorporeal membrane oxygenation as a bridge to lung transplantation: what lessons might we learn from volume and expertise?

Interactive Cardiovascular and Thoracic Surgery
Jeremiah W Awori HayangaJonathan D'Cunha

Abstract

We sought to evaluate the effect of centre volume on survival when extracorporeal membrane oxygenation (ECMO) is used as a bridge to lung transplantation (LTx). We performed a retrospective analysis of the United Network for Organ Sharing data on adult lung transplantations performed between 2000 and 2014. Centres were categorized based on volume of transplants into low-, medium- and high-volume centres (1-5, 6-15 and >15, respectively). Baseline characteristics were assessed and a Kaplan-Meier analysis was used to estimate survival with log-rank test. We used multivariate Cox regression analysis to estimate the risk of post-transplant 1-year mortality between centres. A total of 342 adult recipients were bridged on ECMO. Of these recipients, 88 (25.7%) were bridged in low, 89 (26%) in medium and 165 (48.2%) in high-volume centres. Patients in medium-volume centres were more likely to be older compared with those in low-volume and high-volume centres with a median age of 56, 46 and 49 years, respectively. High-volume centres reported the highest proportion (94.6%) of bilateral lung recipients, followed by low-volume (86.4%) and medium-volume centres (77.5%). The 30-day survival for the three groups was similar but 1-year surviv...Continue Reading

References

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Citations

Jan 26, 2018·Expert Review of Respiratory Medicine·Jens Gottlieb, Mark Greer
Nov 15, 2019·Acute and Critical Care·Jin Gu LeeHyo Chae Paik
Jan 3, 2020·Seminars in Cardiothoracic and Vascular Anesthesia·J W Awori HayangaHeather K Hayanga
Oct 25, 2020·Artificial Organs·Justyna SwolRoberto Lorusso
Apr 23, 2019·The Annals of Thoracic Surgery·Alison L HalpernMichael J Weyant
Dec 19, 2017·The Journal of Thoracic and Cardiovascular Surgery·Konrad HoetzeneckerMarcelo Cypel
Apr 13, 2021·Current Transplantation Reports·Basil S NasirMatthew Hartwig
May 25, 2021·Seminars in Respiratory and Critical Care Medicine·Hanne BeeckmansRobin Vos
May 28, 2021·The Annals of Thoracic Surgery·Ankit DhamijaJ W Awori Hayanga

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